Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

NSAIDS okay for tonsillectomy, new study finds

20.04.2005


When children have their tonsils removed, nonsteroidal anti-inflammatory drugs can be used for pain relief with no significant increase in bleeding and with less nausea and vomiting, according to a systematic review of current evidence.



NSAIDs include analgesics such as ibuprofen (Motrin) and naproxen (Aleve). Although these drugs are proven painkillers they also interfere with blood clotting, so there has been concern about excessive bleeding during or after surgery. Such problems are particularly risky for young tonsillectomy patients, because they have relatively small airways and low blood volume compared to adults.

Although doctors in the United Kingdom seem to be turning toward NSAIDs to reduce the stomach upset that frequently follows narcotic use, many in the United States prefer different surgical techniques that avoid discomfort and different drugs for the pain.


Dr. Mary Cardwell of North Manchester General Hospital in England led a team that reviewed 13 randomized controlled trials that compared NSAIDs with other painkillers or placebo after pediatric tonsillectomy. The studies included 955 children through age 16.

All of the trials analyzed whether severe bleeding that required additional surgery occurred more frequently when NSAIDS were used instead of other painkillers. However, such events are rare under any circumstances. "All the papers studied had insufficient numbers to be able to demonstrate any significant difference," note the authors.

Seven trials involving 471 children looked at bleeding that could be controlled without a return to the operating room, and use of NSAIDs did not increase the frequency of these complications.

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Dr. Gretchen Siviter, a coauthor of the study and an anesthesiologist at England’s Royal Lancaster Infirmary, says use of nonsteroidals in the United Kingdom is "definitely an issue."

"They’re proven to be good analgesics, but some doctors don’t give them because they’re worried about bleeding. I think the review might make people feel a bit easier about giving them."

In the United States, many doctors seem to be taking a different approach. In fact, many patient advisories specifically say that NSAIDs should be avoided before and after surgery.

"Acetaminophen is used much more than nonsteroidals here in the States," says Dr. Julie L. Wei of University of Kansas Medical Center. "We send everybody home with Tylenol combined with a narcotic like codeine for up to seven days."

Dr. Todd G. Dray, chief of head and neck surgery at Kaiser Permanente’s Santa Clara Medical Center in California, agrees that American doctors are generally not looking toward NSAIDs to improve surgical recovery.

"My take on the issue is that the real ’bang for the buck’ in decreasing post-op tonsillectomy pain is coming from improved surgical techniques," he says. At least five new approaches make use of ultrasound, radiofrequency energy or lasers to break up and remove tissue, rather than conventional cutting or burning. Dray has relied exclusively on the new procedures for the past five years.

Both Wei and Dray also note that it is now common to give a steroid such as dexamethasone during surgery to minimize later nausea and vomiting.

Using these methods, says Dray, the need for narcotic painkillers decreases tremendously, and many patients can go home in less than three hours. He believes that rather than turning to NSAIDs, it’s preferable to rely on "medications and techniques that do not potentially increase post-op tonsillectomy bleeding."

Mary Caldwell | EurekAlert!
Further information:
http://www.cfah.org
http://www.cochrane.org

More articles from Studies and Analyses:

nachricht WAKE-UP provides new treatment option for stroke patients | International study led by UKE
17.05.2018 | Universitätsklinikum Hamburg-Eppendorf

nachricht First form of therapy for childhood dementia CLN2 developed
25.04.2018 | Universitätsklinikum Hamburg-Eppendorf

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: LZH showcases laser material processing of tomorrow at the LASYS 2018

At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.

At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...

Im Focus: Self-illuminating pixels for a new display generation

There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?

At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...

Im Focus: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

Im Focus: Dozens of binaries from Milky Way's globular clusters could be detectable by LISA

Next-generation gravitational wave detector in space will complement LIGO on Earth

The historic first detection of gravitational waves from colliding black holes far outside our galaxy opened a new window to understanding the universe. A...

Im Focus: Entangled atoms shine in unison

A team led by Austrian experimental physicist Rainer Blatt has succeeded in characterizing the quantum entanglement of two spatially separated atoms by observing their light emission. This fundamental demonstration could lead to the development of highly sensitive optical gradiometers for the precise measurement of the gravitational field or the earth's magnetic field.

The age of quantum technology has long been heralded. Decades of research into the quantum world have led to the development of methods that make it possible...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

 
Latest News

Research reveals how order first appears in liquid crystals

23.05.2018 | Life Sciences

Space-like gravity weakens biochemical signals in muscle formation

23.05.2018 | Life Sciences

NIST puts the optical microscope under the microscope to achieve atomic accuracy

23.05.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>